(Post title from Othello.)
Last night, Arieh and I were doing some much needed spring cleaning of the spare room in our apartment. It has essentially turned into the "random stuff dumping ground" of the apartment, and seeing as we're hosting a large couple's dinner Friday night, we should prolly clean it up :)
Cleaning out old stuff is always fun- finding old photos, notes, and all sorts of things to reminisce. I found the box where we've kept a good deal of wedding ephemera: RSVP cards, unsent invitations, all the cards from both my shower and the wedding. I had forgotten about the very special gift my mother had given me: an Irish handkerchief that with a few stitches and some ribbon, turns into a Christening bonnet for your newborn* (that, hopefully they will undo the stitches and carry it on their wedding day as a hankie, etc.)
*Allow me to clarify: I'm of Irish descent on my mom's side, so it was important to have some kind of reflection of my Irish heritage at my very Jewish wedding. I carried the hanky down the aisle, wrapped around my bouquet. Since I obviously wouldn't use it for a Christening, I had still planned on using it for a bris or naming ceremony for our future firstborn.
I was all happy and jovial and in the domestic spring cleaning spirit and BAM! It was like I was hit with a sack of bricks in the face. I showed Arieh, my eyes already brimming with tears and without hesitation he says: "Of course we're going to use that! You better not throw it away." And I didn't, of course. It's one of my favorite wedding keepsakes. I tucked it back into the storage box and swallowed the lump in my throat.
Navigating the Land of IF has been an excellent read so far. It's witty, well-written, and painfully honest. Early on, Ford discusses the need to practice "emotional rationing." We need to be acutely aware of our emotional stores and recognize what drains us and what fills us up, and to balance appropriately. Sometimes, we need to ration our emotional stores- saving up for a big event that could otherwise tear us down. It could be buying baby shower gifts all at once, wrapping and labeling them, and keeping them in a closet, ready to go for a random shower when we just don't have the energy to go out and face an onslaught of baby goods. It could be about RSVP-ing to a cousin's shower and opting out of a coworker's shower in the same month. Maybe it's having a good cry on the way home from the event. Really, it's about knowing what you can and cannot handle, and how to cope and respond appropriately.
This has got me thinking about what could end up being a disastrous week in May: my 27th birthday, my followup dr's appt, and then a baby shower- all scheduled within less than a week of one another. I'm thinking I should really reschedule the doctor's appt if I can to the week before. It all depends on whether or not the test results are back yet. If I can't, I'm not sure how I'm going to be able to handle it.
The last few days, I've been wicked down on myself. Not knowing whether this is a genetic or autoimmune issue, but feeling fundamentally cheated either way: either there's a defect within every single cell of my body, or that my own body can't stop attacking itself. Today I'm doing a lot better- mostly b/c I have a rockin' husband who knows just what to say and how to kick my ass into gear. But it certainly reassures this mantra of taking it one day at a time.
April 29, 2009
TMI: Hot flashes abound!
Oh em gee... if this is what normal menopause is like, then women of the 40-55 age range, you have my utmost respect.
Holy jeebus... I've been having hot flashes every day this week. And night sweats. I'm not sure which is worse yet. Add to the unseasonably warm weather in New England (it got up to 92° yesterday), and the complete lack of ventilation in my office... I am sweating up a storm! And they happen so randomly. I am practically chugging water at my desk to keep from feeling faint. Last night I got paranoid and thought maybe I've just been running a fever (yanno, that whole swine flu thing... can I just add how annoying the word "swine" is? Can we just call it pig flu?), so in the middle of a hot flash, I grabbed the thermometer. Nope, no fever. Just a hot flash.
I've also had 2 migraines in a 7-day period- not cool. Not cool at all. I'm not sure if Monday night's migraine was hormonally triggered or not- I did have a bit too much aged cheddar at lunch and again as a pre-dinner snack, so that might have done it.
Arieh wants me to call Dr. Gross and see if he can prescribe me any hormones right now to ease the symptoms, but I'm reluctant to add things to my system while I'm still in a diagnostic phase. The only supplements I'm taking right now are a women's multivitamin in the evening, and a Vitamin D pill with my Levoxyl in the morning. Dr. Gross did acknowledge that HRT is the way to go eventually, and we'll have to work very closely to determine the lowest dose of estrogen I can take so as not to trigger a) migraines or b) a stroke. I will find it strangely hysterical if I get put on the pill. Hell, I think it's hysterical that the pill could get me to ovulate if I end up having just adrenal issues. What's even funnier is that the birth control pill I had taken for 8 years may not have actually done what it was supposed to at all, and I actually carried a higher risk of getting pregnant this whole time.
Go fig. ;)
Interestingly enough, the hot flashes have been 90% of my symptoms. More headaches, a few more migraines than normal, and general insomnia, but that can be written off as stress. Anyone out there have any good recommendations for dealing with hot flashes?
Holy jeebus... I've been having hot flashes every day this week. And night sweats. I'm not sure which is worse yet. Add to the unseasonably warm weather in New England (it got up to 92° yesterday), and the complete lack of ventilation in my office... I am sweating up a storm! And they happen so randomly. I am practically chugging water at my desk to keep from feeling faint. Last night I got paranoid and thought maybe I've just been running a fever (yanno, that whole swine flu thing... can I just add how annoying the word "swine" is? Can we just call it pig flu?), so in the middle of a hot flash, I grabbed the thermometer. Nope, no fever. Just a hot flash.
I've also had 2 migraines in a 7-day period- not cool. Not cool at all. I'm not sure if Monday night's migraine was hormonally triggered or not- I did have a bit too much aged cheddar at lunch and again as a pre-dinner snack, so that might have done it.
Arieh wants me to call Dr. Gross and see if he can prescribe me any hormones right now to ease the symptoms, but I'm reluctant to add things to my system while I'm still in a diagnostic phase. The only supplements I'm taking right now are a women's multivitamin in the evening, and a Vitamin D pill with my Levoxyl in the morning. Dr. Gross did acknowledge that HRT is the way to go eventually, and we'll have to work very closely to determine the lowest dose of estrogen I can take so as not to trigger a) migraines or b) a stroke. I will find it strangely hysterical if I get put on the pill. Hell, I think it's hysterical that the pill could get me to ovulate if I end up having just adrenal issues. What's even funnier is that the birth control pill I had taken for 8 years may not have actually done what it was supposed to at all, and I actually carried a higher risk of getting pregnant this whole time.
Go fig. ;)
Interestingly enough, the hot flashes have been 90% of my symptoms. More headaches, a few more migraines than normal, and general insomnia, but that can be written off as stress. Anyone out there have any good recommendations for dealing with hot flashes?
April 28, 2009
The results are in...
Sorry for the delay in posting about Friday's appointment. Work has been busy, and I just needed the weekend to relax and take my mind off of all of it. If this post feels a bit sterile, it's b/c I'm battling a raging migraine right now, and honestly, I'm just pooped from thinking about all things IF right now.
POF has been confirmed. My FSH, LH, and estradiol levels were virtually the same as they were just over a month ago, thus confirming that yes, my ovary isn't working right. My pituitary gland is pumping out tons of FSH to compensate for the lack of estradiol.
Now that the issue has been identified, finding the cause will guide the next steps in terms of family planning. I had seven - yes, seven - vials of blood drawn after my appt Friday. Not only am I a terrible draw to begin with (thin, spongey veins that roll easily), using a butterfly needle (my SOP when it comes to blood draws) took for. ev. er. to draw all that blood and has left me with two huge, ugly bruises on my arm that a coworker half-jokingly asked if I was being abused at home. And it's not the inside of my arm- we're talking about 4" from my elbow on my left forearm... had to hit the same vein twice. It was pretty agonizing. I came this close to passing out b/c I made the mistake of watching her draw my blood.
So, 2 possible scenarios I'm being tested for:
1. Fragile X syndrome: a chromosomal defect affecting part of my X chromosome. Normally, this causes severe mental retardation. I suppose I'm "lucky" in that my manifestation would only affect my sex glands and basically, I've run out of eggs entirely. Fun.
2. Anti-adrenal antibodies: my body could be attacking itself. Dr. Gross described it as this: my body could be creating these antibodies that are blocking my ovarian follicles. My pituitary gland is pumping out these hormones, but it's like my ovary is wearing ear muffs and can't hear the signal to ovulate.
If I have just Fragile X, I'm up shit's creek re: having my ownbiological genetic children. At this point, I've already cut my losses emotionally. If I have just antiadrenal issues, then there is anecdotal evidence to support that I may ovulate on my own using either birth control or recombinant-FSH. In other words, it's a long-shot at best that I'll have my own biological genetic children. Health-wise, I would need to take supplements to fix the lack of adrenal function, and wear a medical ID bracelet b/c the first thing I'd need in an accident is a cortisol shot.
If I have both, which is a possiblity, then it just gets super sad. Because yes, I could, with longshot odds, have my own children, but do I really want to pass on the same genetic defect? And I think ethically, a fertility clinic wouldn't allow that anyway. So.... yeah. That sucks.
Playing the waiting game again. Next appointment is May 29. Genetic & antibody testing takes a lot longer than just straight up hormone testing, so I get to wait a lot longer for these results. That should be a fun appt just a few days after my 27th birthday, and the day before one of my good friend's baby shower. Hooray!
Do I sound bitter? I am.
On the plus side: got my copy of Navigating the Land of IF, by the fabulous Melissa Ford, maintainer of Stirrup Queens. So far, the book is exactly what I've needed emotionally. I will post a review once I've finished it.
POF has been confirmed. My FSH, LH, and estradiol levels were virtually the same as they were just over a month ago, thus confirming that yes, my ovary isn't working right. My pituitary gland is pumping out tons of FSH to compensate for the lack of estradiol.
Now that the issue has been identified, finding the cause will guide the next steps in terms of family planning. I had seven - yes, seven - vials of blood drawn after my appt Friday. Not only am I a terrible draw to begin with (thin, spongey veins that roll easily), using a butterfly needle (my SOP when it comes to blood draws) took for. ev. er. to draw all that blood and has left me with two huge, ugly bruises on my arm that a coworker half-jokingly asked if I was being abused at home. And it's not the inside of my arm- we're talking about 4" from my elbow on my left forearm... had to hit the same vein twice. It was pretty agonizing. I came this close to passing out b/c I made the mistake of watching her draw my blood.
So, 2 possible scenarios I'm being tested for:
1. Fragile X syndrome: a chromosomal defect affecting part of my X chromosome. Normally, this causes severe mental retardation. I suppose I'm "lucky" in that my manifestation would only affect my sex glands and basically, I've run out of eggs entirely. Fun.
2. Anti-adrenal antibodies: my body could be attacking itself. Dr. Gross described it as this: my body could be creating these antibodies that are blocking my ovarian follicles. My pituitary gland is pumping out these hormones, but it's like my ovary is wearing ear muffs and can't hear the signal to ovulate.
If I have just Fragile X, I'm up shit's creek re: having my own
If I have both, which is a possiblity, then it just gets super sad. Because yes, I could, with longshot odds, have my own children, but do I really want to pass on the same genetic defect? And I think ethically, a fertility clinic wouldn't allow that anyway. So.... yeah. That sucks.
Playing the waiting game again. Next appointment is May 29. Genetic & antibody testing takes a lot longer than just straight up hormone testing, so I get to wait a lot longer for these results. That should be a fun appt just a few days after my 27th birthday, and the day before one of my good friend's baby shower. Hooray!
Do I sound bitter? I am.
On the plus side: got my copy of Navigating the Land of IF, by the fabulous Melissa Ford, maintainer of Stirrup Queens. So far, the book is exactly what I've needed emotionally. I will post a review once I've finished it.
April 24, 2009
It's Like Final Exams in my Vagina
Pillowman was excellent last night. For a student production, that was one impressive performance, from acting to design- the set design really was brilliant. It was a nice distraction for a few hours, but when I got home, I started doing some last minute reading and research, filling in my husband along the way so he has some basis for understanding at 3pm today.
Whether it was asking the obvious "Well, can you just lower your FSH?" to getting into more detailed discussions on hormonal balances, Clomid, injectables, IVF protocol, etc.; it felt like I was studying for a final exam more than getting ready for a doctor's appointment.
The migraine then, was a relief. I popped a few Advil and conked out much easier than if I didn't have the migraine. In fact, I got one of the best night's sleep in a while last night.
I have been trying not to think about it all morning, and so far, it's worked. Busy day at work: interview, finishing a newsletter, working an open house, and I even get to leave an hour earlier today b/c I worked 10 hours on Wednesday. I am trying desperately to remain positive, despite knowing the potential outcome of today's appt.
Whether it was asking the obvious "Well, can you just lower your FSH?" to getting into more detailed discussions on hormonal balances, Clomid, injectables, IVF protocol, etc.; it felt like I was studying for a final exam more than getting ready for a doctor's appointment.
The migraine then, was a relief. I popped a few Advil and conked out much easier than if I didn't have the migraine. In fact, I got one of the best night's sleep in a while last night.
I have been trying not to think about it all morning, and so far, it's worked. Busy day at work: interview, finishing a newsletter, working an open house, and I even get to leave an hour earlier today b/c I worked 10 hours on Wednesday. I am trying desperately to remain positive, despite knowing the potential outcome of today's appt.
April 23, 2009
29 hours, but who's counting?
I'm really not looking forward to tomorrow at 3pm. In fact, I am going batshit insane over tomorrow.
There's just something about hearing your diagnosis in person that fills me with dread. And while I know that this followup could cover anything, I'm pretty sure POF will be the solid diagnosis. I need to really mentally prepare myself for tomorrow, and I haven't at all. I've been lil Miss Escapism for the last two weeks (friends of ours lent us their DVDs of Battlestar Galactica, and we've starting averaging about 3 episodes a night... we're almost halfway through the series).
I've done a lot of work researching, preparing, telling myself I'm beautiful, I'm just as much of a woman, a wife, and someday a mother- that this isn't some kind of punishment from God, or that I did something or didn't do something to cause this. I've had a non-stop inner monologue for over a month. I feel like a lot of it is slowly eroding away in anxious anticipation of tomorrow. A can tell you- I do a great job of psyching myself out for things. The takeaway lesson: I need to do a better job of managing my stress.
After reposting my NIAW info on my FB page, I've had 3 people I've known "come out" to me about their struggles with infertility. Just based on how different all three people are, it's humbling to see that IF can really strike anyone. I'm so sad that this is something I share in common with them, but I'm strengthened by having this new support network of people I know who can really relate to this.
Tonight: more escapism. A and I have 2 tickets to a local production of The Pillowman (a very dark, inventive play). Tomorrow I have an open house to work, then lunch, then this appt.
28.5 hours.
There's just something about hearing your diagnosis in person that fills me with dread. And while I know that this followup could cover anything, I'm pretty sure POF will be the solid diagnosis. I need to really mentally prepare myself for tomorrow, and I haven't at all. I've been lil Miss Escapism for the last two weeks (friends of ours lent us their DVDs of Battlestar Galactica, and we've starting averaging about 3 episodes a night... we're almost halfway through the series).
I've done a lot of work researching, preparing, telling myself I'm beautiful, I'm just as much of a woman, a wife, and someday a mother- that this isn't some kind of punishment from God, or that I did something or didn't do something to cause this. I've had a non-stop inner monologue for over a month. I feel like a lot of it is slowly eroding away in anxious anticipation of tomorrow. A can tell you- I do a great job of psyching myself out for things. The takeaway lesson: I need to do a better job of managing my stress.
After reposting my NIAW info on my FB page, I've had 3 people I've known "come out" to me about their struggles with infertility. Just based on how different all three people are, it's humbling to see that IF can really strike anyone. I'm so sad that this is something I share in common with them, but I'm strengthened by having this new support network of people I know who can really relate to this.
Tonight: more escapism. A and I have 2 tickets to a local production of The Pillowman (a very dark, inventive play). Tomorrow I have an open house to work, then lunch, then this appt.
28.5 hours.
April 22, 2009
National Infertility Awareness Week: April 25 - May 2, 2009
RESOLVE is sponsoring National Infertility Awareness Week, starting this Saturday. Not only do they have a list of 7 things you can do in 7 days, they are also doing 7 days of free teleseminars on various subjects surrounding IF, as well as many local face-to-face events around the country.
I've signed up for the first seminar on Sunday, 4/26 at 4pm: Getting the Support You Need for the Journey Through Infertility - I think that's a good starting point for me anyway, especially since I'm getting my Dx confirmed in 3 days. But there are 7 days worth of excellent topics from affording ART/adoption to egg donation to advocating for family building legislation. I'll try out this first seminar and see how it goes before I register for more.
The ol' college activist in me is feeling inspired. I think it's because by involving myself in some kind of advocacy role, I reestablish a sense of control. Man, IF is a bitch if you're a control-freak like I am. ;)
Oh, and I deleted the post on my FB page about NIAW, b/c I don't think I'm ready to share this yet with people I haven't seen since kindergarten and semi-professional networked contacts. Yeah, yeah, I know folks could have seen it before it was deleted, but whatever. Maybe it's just superstition that I don't resign myself to this yet before I'm "officially" diagnosed on Friday.
EDIT: I re-outed myself and reposted the link/announcement on my FB page, after I found out someone from high school messages me to tell me they are in the same boat. If my voice can give courage and support to others, than it's super important for me to speak out.
Outing Myself
I totally just outed myself on Facebook, with a plug for National Infertility Awareness Week. For the 500+ "friends" I have on FB, my business is now totally out in the open. Still not sure yet if this was a good idea, but damned if I don't feel better.
April 21, 2009
The Waiting Game
Blood just drawn, and despite my best efforts, they went in through the back of my hand. The lab tech was pretty good; quick, patient, and hopefully minimal to no bruising.
Predictions: FSH very high, LH mid range normal, estradiol very low.
Won't know anything until Friday's appt, or if my doc emails me the lab results beforehand. One of the trends I've seen among the IF blogs is this sense of waiting, of helplessness... of things left out of our hands. Whether it's the 2ww, or the first beta, the first u/s, to share news with family and friends, that next checkup... we're left trying to think of just about anything but. It's this constant level of anxiety, just hovering at the end of every thought, every sentence. Always hoping for the best and dreading something coming out of left field. I know POF is more than just IF issues. It's lifelong health issues, and I'm terrified they're going to find something else. Some complication. Something else I wasn't prepared for.
The last few weeks, the ball has been in my court. I've been researching, reading, blogging - giving myself some sense of control. Emotionally readying myself for the long journey ahead knowing that my POF Dx is pretty solid, just based on my initial numbers, always knowing that Dx part 2 was just around the corner. This morning, with a butterfly needle and a half-distracted lab tech who took a personal call while she drew my blood, the ball is out of my court.
So much for that Zen-like state from this weekend. I'm a basketcase already and I only just had my blood drawn 30 min ago... how on earth am I supposed to make it until Friday at 3pm? Waiting, waiting... to hear the inevitable in person.
At least my husband was with me this morning (he also needed blood work done), and he'll be with me on Friday. He really is my strength sometimes.
Predictions: FSH very high, LH mid range normal, estradiol very low.
Won't know anything until Friday's appt, or if my doc emails me the lab results beforehand. One of the trends I've seen among the IF blogs is this sense of waiting, of helplessness... of things left out of our hands. Whether it's the 2ww, or the first beta, the first u/s, to share news with family and friends, that next checkup... we're left trying to think of just about anything but. It's this constant level of anxiety, just hovering at the end of every thought, every sentence. Always hoping for the best and dreading something coming out of left field. I know POF is more than just IF issues. It's lifelong health issues, and I'm terrified they're going to find something else. Some complication. Something else I wasn't prepared for.
The last few weeks, the ball has been in my court. I've been researching, reading, blogging - giving myself some sense of control. Emotionally readying myself for the long journey ahead knowing that my POF Dx is pretty solid, just based on my initial numbers, always knowing that Dx part 2 was just around the corner. This morning, with a butterfly needle and a half-distracted lab tech who took a personal call while she drew my blood, the ball is out of my court.
So much for that Zen-like state from this weekend. I'm a basketcase already and I only just had my blood drawn 30 min ago... how on earth am I supposed to make it until Friday at 3pm? Waiting, waiting... to hear the inevitable in person.
At least my husband was with me this morning (he also needed blood work done), and he'll be with me on Friday. He really is my strength sometimes.
April 20, 2009
A Little (Much Needed) R & R
This weekend A and I took a "daycation" out to the farthest corner of our state to just relax and get away from everyone and everything, even if just for 24 hours. No email, no internet, no phone calls... nothing. Just "us" time.
Between A's layoff and my Dx, we really just needed a weekend to ourselves to focus on ourselves. A nice dinner. A movie. Some wine. A comfy bed. A scenic area we'd never been to. Hell, we even worked in a couple of hours at an art museum, something we haven't done in a while. The best part of all, is that most of the times we asked each other, in our comfortable moments of silence: "Whatcha thinkin' about?" we answered: "Nothing."
No questions for the doctor. No fears about other hidden issues or diseases. No profound sadness over the fact I probably won't have biological children, or reluctant acceptance that egg donors will probably be the way to go. No feelings of disappointment- to my husband, my family, my friends... myself.
It was only 24 hours, and yet, it did wonders for my emotional state over the last month.
Tomorrow I get my estradiol, FSH, and LH retested. (Note to self: drink water continuously between now and tomorrow morning so they don't have to draw blood from the backs of my hands like last time.)
Friday, it's sit-down with the doctor time. Thankfully this is a busy week at work, and I've had a great weekend to wind down to an almost Zen-like stopping point, so hopefully, I won't be completely off the walls by Friday afternoon.
Between A's layoff and my Dx, we really just needed a weekend to ourselves to focus on ourselves. A nice dinner. A movie. Some wine. A comfy bed. A scenic area we'd never been to. Hell, we even worked in a couple of hours at an art museum, something we haven't done in a while. The best part of all, is that most of the times we asked each other, in our comfortable moments of silence: "Whatcha thinkin' about?" we answered: "Nothing."
No questions for the doctor. No fears about other hidden issues or diseases. No profound sadness over the fact I probably won't have biological children, or reluctant acceptance that egg donors will probably be the way to go. No feelings of disappointment- to my husband, my family, my friends... myself.
It was only 24 hours, and yet, it did wonders for my emotional state over the last month.
Tomorrow I get my estradiol, FSH, and LH retested. (Note to self: drink water continuously between now and tomorrow morning so they don't have to draw blood from the backs of my hands like last time.)
Friday, it's sit-down with the doctor time. Thankfully this is a busy week at work, and I've had a great weekend to wind down to an almost Zen-like stopping point, so hopefully, I won't be completely off the walls by Friday afternoon.
April 16, 2009
Book Review: "And Hannah Wept" by Michael Gold
Finished And Hannah Wept: Infertility, Adoption, and the Jewish Couple by Michael Gold. It's currently out of print, and was first published in 1988... so, the information is a bit dated (IVF was apparently still highly experimental at the time the book was published). I enjoyed and appreciated its expansive breadth of material, but didn't feel neccesarily as satisfied emotionally reading it.
The book covers halakha (Jewish law) pretty extensively, and how different passages in Torah, Talmud, and Midrash basically permit just about anything when it comes to infertility treatments. Sometimes I felt as though the book got too bogged down into technicality in terms of Jewish law; for the Orthodox couple, I can see the relevance and importance of finely splicing out exact parameters of what is and is not permitted by Jewish law (treatments on the Sabbath, the use of donor eggs or sperm, the acceptability of semen testings, for example). But for the less observant Jew looking to find comfort in her faith, And Hannah Wept delved just a bit too far for my taste.
Is it a good resource? Yes. Do I feel reconnected to my faith? Absolutely. Does it offer the latest information about the latest advances out there? Not so much. But what it does is it contextualizes the experience of infertility through the Jewish perspective in a way that makes the most sense according to Jewish law.
What I most appreciated about this book was that it doesn't place the burden of fault with the infertile couple, as I've encountered in some other Jewish resources. True, 3 of the 4 Matriarchs were infertile, and it was their prayers that were answered by God that ultimately restored their fertility, but Gold acknowledges this is a not a realistic approach to modern issues of infertility. He argues that Judaism teaches couples facing IF to pursue aggressively, in all their power, to be able to fulfil God's first commandment of "be fruitful and multiply." This is one of the few Jewish resources on IF where I don't feel like I brought this on myself, or that God is testing me in some cruel way.
Still nervous as hell about next Friday. Trying to stay positive and keep myself as distracted as possible.
The book covers halakha (Jewish law) pretty extensively, and how different passages in Torah, Talmud, and Midrash basically permit just about anything when it comes to infertility treatments. Sometimes I felt as though the book got too bogged down into technicality in terms of Jewish law; for the Orthodox couple, I can see the relevance and importance of finely splicing out exact parameters of what is and is not permitted by Jewish law (treatments on the Sabbath, the use of donor eggs or sperm, the acceptability of semen testings, for example). But for the less observant Jew looking to find comfort in her faith, And Hannah Wept delved just a bit too far for my taste.
Is it a good resource? Yes. Do I feel reconnected to my faith? Absolutely. Does it offer the latest information about the latest advances out there? Not so much. But what it does is it contextualizes the experience of infertility through the Jewish perspective in a way that makes the most sense according to Jewish law.
What I most appreciated about this book was that it doesn't place the burden of fault with the infertile couple, as I've encountered in some other Jewish resources. True, 3 of the 4 Matriarchs were infertile, and it was their prayers that were answered by God that ultimately restored their fertility, but Gold acknowledges this is a not a realistic approach to modern issues of infertility. He argues that Judaism teaches couples facing IF to pursue aggressively, in all their power, to be able to fulfil God's first commandment of "be fruitful and multiply." This is one of the few Jewish resources on IF where I don't feel like I brought this on myself, or that God is testing me in some cruel way.
Still nervous as hell about next Friday. Trying to stay positive and keep myself as distracted as possible.
Questions for 4/24 appointment
My followup visit to my initial diagnosis is next Friday, 4/24. I'm having my FSH, LH, and estradiol retested on Tuesday. I'm assuming that since I haven't bled and it's been over 2 weeks since my progesterone challenge, my estradiol levels will continue to be low, my FSH high, and my LH just hanging out in mid-range levels.
I have been having minor panic attacks and just general anxiety over this appointment... the waiting is killing me, and yet, I know I'm just going to hear in person what I've already been told via email, and I'm sure emotionally, I'm going to feel like I did the day I first found out. Thankfully, I will have my husband there with me, and in a way, we've been kind of emotionally preparing ourselves for this, but it still doesn't make the waiting easier.
Since my Dx email, Dr. Gross has recommended that I compile a list of questions to email to him before the appointment. I've been researching like a fiend, and so far, here's the lists that I've come up with. I'm certainly open to suggestions that anyone might have.
Next Steps
I have been having minor panic attacks and just general anxiety over this appointment... the waiting is killing me, and yet, I know I'm just going to hear in person what I've already been told via email, and I'm sure emotionally, I'm going to feel like I did the day I first found out. Thankfully, I will have my husband there with me, and in a way, we've been kind of emotionally preparing ourselves for this, but it still doesn't make the waiting easier.
Since my Dx email, Dr. Gross has recommended that I compile a list of questions to email to him before the appointment. I've been researching like a fiend, and so far, here's the lists that I've come up with. I'm certainly open to suggestions that anyone might have.
Next Steps
- Any speculation as to what may have caused this?
- What is the likelihood that my high FSH could be the result of my unilateral ovariectomy combined with coming off hormonal birth control?
- Should I be tested for any autoimmune disorders given POF and my hypothyroidism (Hashimoto's thyroidosis, Lupus, etc.)?
- Barring any autoimmune disorders, what are the implications for my health with a diagnosis of POF combined with hypothyroidism?
- Should my remaining ovary be monitored for any complications with any cysts, if present?
- What are the next steps in terms of any further diagnostic testing? (FHS, LH, estradiol to be tested 4/21; Autoimmune disorders if suspected; Ultrasound on right ovary?)
- Based on my numbers, is spontaneous ovulation a possibility?
- Do my current hormone levels/hypothyroidism affect the consistency of cervical mucus?
- Can I still rely on fertility awareness to monitor possible ovulation?
- Is is possible for women with POF to sustain a pregnancy to term, whether naturally or through IVF (given that women with a high FSH have a greater risk of miscarraige?
- How can I determine if anything is left in my ovarian reserve? Should I have Anti-Mullerian Hormone testing done? What does this entail? Timeline?
- If there are eggs to be saved, can they be retrieved? Frozen? How long are they good for?'
- Should my husband have semen analysis performed? When?
- In terms of timeline for pursuing any artificial reproductive technology, what would you recommend?
- Given that I was instructed to go off hormonal birth control, is hormone replacement therapy a realistic treatment option for me? Do the benefits outweigh the costs?
- Cholesterol: I know this is exacerbated by hypothyroidism. Is the POF contributing at all as well? Will HRT help in treating cholesterol issues as well?
- What kind of supplements would you recommend (calcium, vitamin D, anything to help with POF or boost fertility)? Are estrogen supplements safe/recommended given my history of migraine?
- Minor menopausal symptoms: hot flashes, dizziness, insomnia, feeling unfocused/spacey; anything I can do to alleviate these symptoms? Anything major I should be on the lookout for?
- Are my testosterone levels a concern? Should anything be done to lower these numbers?
- Are there any clinical trials worth investigating? Thoughts on clinical trials/studies of POF in general?
- Do you have any recommendations for infertility-sensitive mental health counseling?
- Do you have any resources for local support groups?
April 14, 2009
Family Building Act of 2009 (H.R. 697)
Fertility issues are about to make their way onto the floor of House of Representatives in Washington. This piece of legislation would require insurers to cover fertility treatments. Obviously, this is a pretty big concern in the IF community.
Don't know when this is going up for a vote, and apparently this has had other forms in both 2005 and 2007, but it's worth being informed and contacting your Representative to co-sponsor this Act today.
Family Building Act of 2009: Full text here
Currently sponsored/supported by the following Representatives as of 4/8/09:
Rep. Steve Cohen (D-TN)
Rep. Barney Frank (D-MA)
Rep. Raul Grijalva (D-AZ)
Rep. Steve Israel (D-NY)
Rep. Barbara Lee (D-CA)
Rep. Nita Lowey (D-NY)
Rep. Jerrold Nadler (D-NY)
Rep. David Price (D-NC)
Rep. Allyson Schwartz (D-PA)
Rep. Debbie Wasserman Schultz (D-FL)
Is your state lacking support? Contact your rep via RESOLVE's online form here.
Don't know when this is going up for a vote, and apparently this has had other forms in both 2005 and 2007, but it's worth being informed and contacting your Representative to co-sponsor this Act today.
Family Building Act of 2009: Full text here
Currently sponsored/supported by the following Representatives as of 4/8/09:
Rep. Steve Cohen (D-TN)
Rep. Barney Frank (D-MA)
Rep. Raul Grijalva (D-AZ)
Rep. Steve Israel (D-NY)
Rep. Barbara Lee (D-CA)
Rep. Nita Lowey (D-NY)
Rep. Jerrold Nadler (D-NY)
Rep. David Price (D-NC)
Rep. Allyson Schwartz (D-PA)
Rep. Debbie Wasserman Schultz (D-FL)
Is your state lacking support? Contact your rep via RESOLVE's online form here.
April 13, 2009
A metaphor on Easter
Today, I "helped" A and my FIL replace an old AC unit. When I say helped I mean adding such witty comments as "Are you sure you cut the hole in the plywood big enough?"
The old AC unit had this crazy huge bird's nest in it, and, as A and his dad were moving things around, I noticed a tiny white speckled egg on the ground next to the house. A thought for sure it was empty, but I gently rolled it with a stick, and it had some weight to it.
MIL got me a garden spade to scoop it up, b/c somewhere as a child I was told not to touch birds eggs because a) they're covered in diseases and b) if the birds smell my scent on the egg, they'll abandon it (I have no idea as to whether either of these things are actually true).
I scooped up the egg, and it was just so light and tiny that it rolled right off the trowel... and cracked on the ground. Little baby egg yolk. Little baby egg white. I am a very sensitive person by nature when it comes to animals, and cue all this crazy emotional stuff lately, and I just felt utterly heartbroken. Like, the one thing I was looking out for, this strange fixation I had on this poor little lonely egg while the guys worked on the AC - I just wanted to make sure it didn't get crushed while they worked in that area.
I found my Easter egg today, and I broke it.
I excused myself to the bathroom to wash my hands (remember: diseases), but mostly to cry for a minute and get myself back together.
Perhaps I put a little too much meaning into things, but I was profoundly saddened by this little random moment today.
The old AC unit had this crazy huge bird's nest in it, and, as A and his dad were moving things around, I noticed a tiny white speckled egg on the ground next to the house. A thought for sure it was empty, but I gently rolled it with a stick, and it had some weight to it.
MIL got me a garden spade to scoop it up, b/c somewhere as a child I was told not to touch birds eggs because a) they're covered in diseases and b) if the birds smell my scent on the egg, they'll abandon it (I have no idea as to whether either of these things are actually true).
I scooped up the egg, and it was just so light and tiny that it rolled right off the trowel... and cracked on the ground. Little baby egg yolk. Little baby egg white. I am a very sensitive person by nature when it comes to animals, and cue all this crazy emotional stuff lately, and I just felt utterly heartbroken. Like, the one thing I was looking out for, this strange fixation I had on this poor little lonely egg while the guys worked on the AC - I just wanted to make sure it didn't get crushed while they worked in that area.
I found my Easter egg today, and I broke it.
I excused myself to the bathroom to wash my hands (remember: diseases), but mostly to cry for a minute and get myself back together.
Perhaps I put a little too much meaning into things, but I was profoundly saddened by this little random moment today.
April 11, 2009
Dreams
I have been a vivid dreamer all of my life. I've been keeping dream journals for a long time now; they're always fun to go back and read. Last night was no exception- full-on complex plot with story arch and character development.
My dream:
From what I can remember, for some reason I was rushed to the ER. I was having strange cramping, and the doctor determined I was ovulating, like, right then. I explained I have POF, and that it was imperative they get that egg STAT. So they wheeled me into another room and my dress (I was wearing a dress, which is weird, b/c I never wear dresses) was up over my legs and they had this HUGE, like 3 foot long needle. "We're going to give you a little anesthesia to numb you up a little bit," says a nurse. I look over at A, who's standing there, just as panicky as I am. I ask him "Are you ready for this? I know we've only talked about going the IVF root, but this might be my one chance so are you ok with like, throwing some sperm in a cup for me right now?"
Aaaaand then I woke up. LOL, whut?
The night before last, I woke up out of a dead sleep, no dream that I can remember, and being completely overwhelmed by the fact that we probably will have to use donor eggs and go IVF. Like, awakened by anxiety. I've never had that happen, even after I was diagnosed with mild panic disorder in college. Nuts. I woke up not once but twice that night- same terror over not being able to have my own kids. WTF mate?
I've noticed that the hardest time of day for me is at night, and sometimes right when I first wake up for the day. The rest of the day, I'm fine for the most part. It's in those still moments of the day where it really gets me. Very strange.
My dream:
From what I can remember, for some reason I was rushed to the ER. I was having strange cramping, and the doctor determined I was ovulating, like, right then. I explained I have POF, and that it was imperative they get that egg STAT. So they wheeled me into another room and my dress (I was wearing a dress, which is weird, b/c I never wear dresses) was up over my legs and they had this HUGE, like 3 foot long needle. "We're going to give you a little anesthesia to numb you up a little bit," says a nurse. I look over at A, who's standing there, just as panicky as I am. I ask him "Are you ready for this? I know we've only talked about going the IVF root, but this might be my one chance so are you ok with like, throwing some sperm in a cup for me right now?"
Aaaaand then I woke up. LOL, whut?
The night before last, I woke up out of a dead sleep, no dream that I can remember, and being completely overwhelmed by the fact that we probably will have to use donor eggs and go IVF. Like, awakened by anxiety. I've never had that happen, even after I was diagnosed with mild panic disorder in college. Nuts. I woke up not once but twice that night- same terror over not being able to have my own kids. WTF mate?
I've noticed that the hardest time of day for me is at night, and sometimes right when I first wake up for the day. The rest of the day, I'm fine for the most part. It's in those still moments of the day where it really gets me. Very strange.
April 10, 2009
Made the Blogroll!
Thanks much to Melissa over at Stirrup Queens! I just made the IF blogroll over there, so I'm looking forward to lots more clickers :) SQ has been so helpful in finding other experiences and stories similar to my own, so I hope my story here can also help others out there.
Also- we're home-home now with family for Passover. It has already felt awesome to see both of our families. I feel much more comforted, relaxed, relieved. I feel like I can let go of this big breath I've been holding for the last couple of weeks. I feel a little more back to center.
Chag Sameach folks.
Also- we're home-home now with family for Passover. It has already felt awesome to see both of our families. I feel much more comforted, relaxed, relieved. I feel like I can let go of this big breath I've been holding for the last couple of weeks. I feel a little more back to center.
Chag Sameach folks.
April 9, 2009
Sarah Laughed: Being Around Babies
Of course, as soon as I posted yesterday's entry, I go to a seder at a friend's house with a 2 year old and a 5 month old present. Of course.
I say Sarah laughed, b/c it's truly one of those "laugh at the universe" kind of moments.
I have always felt a little awkward around small children. Last night, I did my best to be social with the 2 year old (who, ate so much matzo I'm pretty sure that child will not poop for a week). And it didn't feel awkward (except when we played "Hotter/Colder" while she went to go find the Afikomen and I used the term "lukewarm." She just kind of blinked at me with a "WFT, I'm 2, I don't know what that means" look on her face). In fact, I felt like, "yeah, I could totally do this." Because as much as I want to be a mother, there are still those lingering doubts of "Can I actually do this? Will I eff this up?"
The real test was when I got to hold and play with the 5 month old. I made her smile and laugh and coo and giggle and it felt great! Holding a baby is totally like IF crack. I was nervous that I'd be anti-social and cranky, but I had a wonderful time, and realized that, at least right now, I can totally be fine being around young children and babies. Not so sure about pregnant women yet. But babies (right now) I can handle.
The best was seeing A's face while I played with the baby. That "Man, when we finally get our chance, you are going to effin' ROCK at this whole mom thing" look.
When we got home, I was sad. Definitely sad. I had my cry, I talked through it, and today, I'm not feeling so bad. One day at a time - this is how I roll. A was such an amazing support to me last night when we came home, and no matter how frustrating and scary and generally sucktastic this whole situation is, he just knows how to make me feel better.
He gives me hope.
I say Sarah laughed, b/c it's truly one of those "laugh at the universe" kind of moments.
I have always felt a little awkward around small children. Last night, I did my best to be social with the 2 year old (who, ate so much matzo I'm pretty sure that child will not poop for a week). And it didn't feel awkward (except when we played "Hotter/Colder" while she went to go find the Afikomen and I used the term "lukewarm." She just kind of blinked at me with a "WFT, I'm 2, I don't know what that means" look on her face). In fact, I felt like, "yeah, I could totally do this." Because as much as I want to be a mother, there are still those lingering doubts of "Can I actually do this? Will I eff this up?"
The real test was when I got to hold and play with the 5 month old. I made her smile and laugh and coo and giggle and it felt great! Holding a baby is totally like IF crack. I was nervous that I'd be anti-social and cranky, but I had a wonderful time, and realized that, at least right now, I can totally be fine being around young children and babies. Not so sure about pregnant women yet. But babies (right now) I can handle.
The best was seeing A's face while I played with the baby. That "Man, when we finally get our chance, you are going to effin' ROCK at this whole mom thing" look.
When we got home, I was sad. Definitely sad. I had my cry, I talked through it, and today, I'm not feeling so bad. One day at a time - this is how I roll. A was such an amazing support to me last night when we came home, and no matter how frustrating and scary and generally sucktastic this whole situation is, he just knows how to make me feel better.
He gives me hope.
April 7, 2009
Happy Passover!
Fascinating post on BlogHer: The Perfect Storm of Holidays: Infertile at Pesach (found via her blog, Stirrup Queens*). Got me thinking about religion, faith, and the Jewish perspective.
Passover starts tonight at sundown. Last night A and I had a really long, thoughtful discussion on faith and God. Initially, I didn't want to celebrate Passover, which, for the most part to me, is attending 1-2 seders and keeping KFP for the week (kosher for Passover). But I've realized over the last week or so, that one of the things I love so much about Passover is that it brings together family, and instead of turning away from the ritual aspects of the holiday, I can instead try and find meaning.
The linked post talks about how Pesach is so enveloped in the idea of children, but I disagree in that it is solely about children- for me, it's about more than children- it's all about family. Since I wasn't born Jewish but rather converted (2 years ago on April 20th!), we only usually have 1 family seder with A's parents. And literally, 9 times out of 10 (b/c I think I've been to at least 10 seders at his parents' house), there are usually no children. The only time I can think of is literally once, and she was maybe 9 years old and unrelated to the family anyway. Add to the fact that I'm open about the IF issue with both of our families, and I'd like to think I've dodged the "So, when are you having kids?" bullet.
Passover tells the story of the Exodus: the Jews are freed from Mitzraim (Egypt), wander around lost for a little bit (read: 40 years) and find God (that whole Mt. Sinai thing). What a great parable for anyone coping with infertility, even the non-religious. Look at the metaphor of "Exodus > 40 years in the desert > Mt. Sinai" as "Diagnosis > Coping > Coming Out a Stronger Person" somehow. To simplify it is not to invalidate the gravity of IF or the profundity of Exodus, but rather to draw a parallel meaning. Thus, re-contextualizing the way I look at the practice of ritual right now allows me to find that meaning, that guidance that I still feel a bit raw over in approaching God directly. Perhaps this Passover marks my Exodus out of a question of faith and toward my Mt. Sinai of accepting God, and thus, this situation (b/c all the Jews at Mt. Sinai chose to accept the 10 Commandments- interesting sidenote here. The Torah was given, but it was up to the free will of each person to accept the Torah).
I'm not dreading Passover. I was this past weekend, but really, I have no reason to. I'll be surrounded by family that loves and cares for us, and thankfully, I shouldn't be around too many wee ones. And if I am, I'll manage. I'm really looking forward to spending the time with family. I think A and I could really use it, especially since this will be the first time we're seeing them since my Dx.
This post has gone on long enough, but I have a whole other post to do re: the Infertile Matriarchs.
*PS... Stirrup Queens is one hell of a resource when it comes to finding other blogs out there about IF. If you haven't checked her out, and are looking for other women, couples, and *gasp!* the elusive male point-of-view, I suggest checking it out.
Passover starts tonight at sundown. Last night A and I had a really long, thoughtful discussion on faith and God. Initially, I didn't want to celebrate Passover, which, for the most part to me, is attending 1-2 seders and keeping KFP for the week (kosher for Passover). But I've realized over the last week or so, that one of the things I love so much about Passover is that it brings together family, and instead of turning away from the ritual aspects of the holiday, I can instead try and find meaning.
The linked post talks about how Pesach is so enveloped in the idea of children, but I disagree in that it is solely about children- for me, it's about more than children- it's all about family. Since I wasn't born Jewish but rather converted (2 years ago on April 20th!), we only usually have 1 family seder with A's parents. And literally, 9 times out of 10 (b/c I think I've been to at least 10 seders at his parents' house), there are usually no children. The only time I can think of is literally once, and she was maybe 9 years old and unrelated to the family anyway. Add to the fact that I'm open about the IF issue with both of our families, and I'd like to think I've dodged the "So, when are you having kids?" bullet.
Passover tells the story of the Exodus: the Jews are freed from Mitzraim (Egypt), wander around lost for a little bit (read: 40 years) and find God (that whole Mt. Sinai thing). What a great parable for anyone coping with infertility, even the non-religious. Look at the metaphor of "Exodus > 40 years in the desert > Mt. Sinai" as "Diagnosis > Coping > Coming Out a Stronger Person" somehow. To simplify it is not to invalidate the gravity of IF or the profundity of Exodus, but rather to draw a parallel meaning. Thus, re-contextualizing the way I look at the practice of ritual right now allows me to find that meaning, that guidance that I still feel a bit raw over in approaching God directly. Perhaps this Passover marks my Exodus out of a question of faith and toward my Mt. Sinai of accepting God, and thus, this situation (b/c all the Jews at Mt. Sinai chose to accept the 10 Commandments- interesting sidenote here. The Torah was given, but it was up to the free will of each person to accept the Torah).
I'm not dreading Passover. I was this past weekend, but really, I have no reason to. I'll be surrounded by family that loves and cares for us, and thankfully, I shouldn't be around too many wee ones. And if I am, I'll manage. I'm really looking forward to spending the time with family. I think A and I could really use it, especially since this will be the first time we're seeing them since my Dx.
This post has gone on long enough, but I have a whole other post to do re: the Infertile Matriarchs.
*PS... Stirrup Queens is one hell of a resource when it comes to finding other blogs out there about IF. If you haven't checked her out, and are looking for other women, couples, and *gasp!* the elusive male point-of-view, I suggest checking it out.
April 6, 2009
Sarah Laughed: A Little Humor
My husband sent me this today. Brilliant. One of the reasons I love him so much- he always knows how to make me laugh.
This man has two children.
This man has two children.
April 5, 2009
Another Video About POF
Here is the full interview featured in the clip I posted a few down below, with tons more info. Very helpful!
Understanding My Quest to Conceive
While we are not officially on our TTC journey yet, this document captures so much of what I've been thinking and going through since my Dx. It's a bit long to post here, but can be found here online:
Understanding My Quest to Conceive
(originally published 2000, Getting Pregnant When You Thought You Couldn't, pgs 199-205, Helane Rosenberg and Yakov Epstein)
We will be making more concrete decisions about family planning after my appt on 4/24 with Dr. Gross. We just yet don't know enough about my own ovarian reserve to know whether or not it's worth it to just try on our own or to use ART (Assisted Reproduction Technology). We just need to talk things through with our medical professional first.
Understanding My Quest to Conceive
(originally published 2000, Getting Pregnant When You Thought You Couldn't, pgs 199-205, Helane Rosenberg and Yakov Epstein)
We will be making more concrete decisions about family planning after my appt on 4/24 with Dr. Gross. We just yet don't know enough about my own ovarian reserve to know whether or not it's worth it to just try on our own or to use ART (Assisted Reproduction Technology). We just need to talk things through with our medical professional first.
Things I Wish I Could Tell People About Grieving My Infertility
Through various online support communities, I came across the list below, originally published here. I wanted to reproduce it in my own blog, expanding with my own thoughts. The bolded items are the original list, and I've added my thoughts below each point.
- I wish you would not be afraid to speak to me about my losses, my infertility, and to ask what you can do to help. Sometimes I feel like people think I have some kind of contagious shame. It is incredibly lonely to bear this burden with just my husband, and to be honest, it's nice to get support from someone other than my spouse.
- If I cry or get emotional when we talk about them, I wish you knew that it isn’t because you have hurt me. The fact that I have suffered has caused my tears. You have allowed me to cry, and I thank you. Crying and emotional outbursts are healing. As I said in my last post, I cry. A lot. I don't think I've ever cried so much before in my life. And it helps in ways I can't describe. And yes, sometimes I like to put Radiohead and Ben Folds and other emo music on loop and cry it out for a set period of time. Because it really does help.
- I wish you wouldn’t pretend that nothing is happening to me, because it is a large part of my life. I need my friends and family by my side. POF is more than just about infertility. It carries lifelong health risks that are just as terrifying as not being able to have your own children. My Dx does not define me, as I have been told, but it does make up a large portion of who I am, and thus, occupies my thoughts. A lot.
- I will have emotional highs and lows, ups and downs. I wish you wouldn’t think that if I have a good day, my grief is over, or that if I have a bad day, I need psychiatric counseling. I can be having a perfectly awesome day and something like seeing matching mother-daughter retro-styled aprons in a store window can totally ruin the rest of the day for me. I literally take this one day at a time.
- Being an infertile person is not contagious, so I wish you wouldn’t shy away from me. POF is not contagious. It affects a very small number of the population. And while it might be on my mind 24/7, I still enjoy your company and talking about scrapbooking and shopping and Wii Fit and going out to eat and Wrestlemania and just hangin out.
- I wish you knew that all of the “crazy” grief reactions I am having are in fact very normal. Depression, anger, frustration, hopelessness, and questioning of values and beliefs are to be expected during and following what is happening to me. I'm kind of going through it all at once. Call me a non-traditionalist when it comes to grieving. But every day is different, and I work through each day one at a time.
- I wish you would understand the physical reactions to grief. I may gain weight or lose weight…sleep all the time or not at all…want to surround myself with business or be all alone, all of which may be related to my grief. It's nothing personal. My husband is an extrovert when it comes to dealing with his grief. He likes to surround himself with others. I am an introvert, but I desperately seek validation for my emotions in others.
- My birthday, anniversaries of the diagnosis, holidays, and the days I find out that this cycle too was a bust, are all terrible times for me. I wish you could tell me that you are thinking about me, and if I get quite withdrawn, just know I am doing my best to cope. Please don’t try to coerce me into being cheerful or tell me that it will be better soon. Arieh has always said that I hold a grudge for life. The day after St. Patrick's day is forever ruined, and not just from the usual post-St. Pat's day hangover. And we haven't even started any fertility treatments yet, so I have no clue what our emotional states will be like once we start that part of our journey.
- It is normal and good that most of us re-examine our faith, values, and beliefs throughout this journey. We will question things we have been taught all our lives, and hopefully come to some new understandings to include those with God. I'm not trying to be pushy, but God and I are not right with each other right now. I'm working through it, and if it looks like I've given up on God, it's nothing personal, and it's not abandonment. I know I'll be back. You can't be angry at something you don't believe in. I just need time.
- I wish you understood that infertility changes people. I am not the same person I was before I experienced it. My entire future family that I have dreamed of sharing with my soulmate has been completely taken away from me. While we may still be parents, it will not be easy for us to get to that point, and it challenges notions of pregnancy achievement that most other couples take for granted. And despite our best hopes, we might never be parents- adoption is not as easy as everyone thinks it is, and it's not for everyone. It is no easy process any way you slice it and will impact so many aspects of our lives, such that, we cannot help but be changed by the experience. I'd like to think that it's not that the old Miriam and Arieh are gone, rather, we are a changed couple with different thoughts on hope, strength, and determination. These things are defined in new ways for us.
My Initial Emotional Response (so far)
Finding out that you probably won't be able to have your own children is such a devastating blow. I remember feeling like there's no way this could be really happening to me for the first couple of days after I found out. Since 3/18, I've been through a lot emotionally. Add to the fact that my husband also just got laid off the day after my Dx... yeah, it's been rough lately.
I cry. A lot. You wouldn't think that you'd think about your ability have children every single day, but I do. I can't help it- there are reminders all around me. Take for example, a simple walk to get the mail with my husband. It's a sunny day, and by the time we get to Davis, I've seen 4 strollers, 1 pregnant woman, and tons of kids. They are everywhere. In the grocery store, on TV... pregnant ladies and babies are all over the place. It's kind of that same scenario when a woman has a pregnancy scare- suddenly, the only commercials on TV are for ClearBlue and Pampers.
If you haven't gathered already, I default to self-deprecating humor. It's a defense mechanism I readily recognize in myself, and honestly, it's just the first way I cope with things. I realize this might make others uncomfortable, b/c they think I'm making light of my own terribly tragic issue. It's not that I'm poking fun, or that I don't realize the gravity of the situation. It's just the easiest way for me to talk about it around other people and not be a blubbering mess. As a writer, this comes of usually as cynicism, so I thought it necessary to preface the rest of this post with this caveat.
The day I found out, I cried so much. I cried at work, cried when I got home, cried during dinner, cried before bed, cried when I got up the next morning. My husband cried with me. He was as sad as I was for all the same reasons, and sadder still to see his wife in so much emotional pain. In that first week following both my Dx and the layoff, our marriage has become foundationally stronger than it has been in the last year. If there's a silver lining to be had in all of this, it's that I know I have indeed, a partner for life, through all of life's sorrows.
For the first week or so, I was stuck in the overwhelming sadness of the situation. I was watching futures disappear: of coming out of the bathroom with a positive HPT in hand, telling Arieh he's going to be a daddy; of seeing my child's face for the first time and playing the "gee, he looks like me or you" game; of surprising family and friends with creative, inventive ways with news that we're pregnant... What made me saddest is that we were deliberately waiting to TTC (try to conceive) for another 2 years, so that I had my master's completed, and we had a bigger nest egg. We were getting all of our ducks in a row because it was important to us that we are financially secure when we're ready to build our family. I felt like I was cheated.
In coping, I've moved into a much angrier stage right now. I'm in the "it's just not fucking fair" stage. Because, well, it's not. I'm taking a lot of my anger out on God right now. The good thing is that I haven't abandoned my faith entirely; you can't be angry at something you don't believe in. That's just a logical fallacy.
I've just finished reading Harold Kushner's When Bad Things Happen to Good People, and while I can rationally internalize the concepts he presents, emotionally, I'm just not ready to accept them. God is not to blame for this. Neither am I. Neither are my doctors. Kushner argues that suffering is not caused by God; it is random and indiscriminant. Kushner validates God's existence, saying that God is here to give us strength to work through our suffering. As His children suffers, so to does God. It's a lot to take in at once, and like I said- I get it, but I'm just not ready to accept it.
It's unfair and it angers me. While I appreciate the comments I've received that "well, there's always adoption or IVF," it's extremely frustrating. Why should I have to pay thousands of dollars to have my own children when millions of women have them for free? Like, I get there are thousands of unwanted babies/children out there, but why should I feel guilty for wanting my own biological children? If children are our legacy, our immortality: imagine how terribly isolating it must feel to know that the gene pool for your family stops at you.
I struggle with feelings of inadequacy. I did when I had my ovary removed too; I described it as though I were a tree with a broken branch at the time. That I wasn't a complete woman. Now, with my ability to have my own children practically robbed from me, the effect has been devastating to my gender identity. I'm not saying I think I'm a dude, but I sure do feel like less of a woman. I feel fat. I feel ugly. I feel useless. Rationally, I know these things are not true. Emotionally, it's a struggle every single day.
I'm fairly convinced at my followup appt on 4/24, my doctor will recommend counseling. Until then, I just continue to write. It's theraputic, and it helps me chronicle my emotional development. It doesn't make any of this necessarily any easier, but at least it's something I can do in a situation where I'm virtually helpless.
I cry. A lot. You wouldn't think that you'd think about your ability have children every single day, but I do. I can't help it- there are reminders all around me. Take for example, a simple walk to get the mail with my husband. It's a sunny day, and by the time we get to Davis, I've seen 4 strollers, 1 pregnant woman, and tons of kids. They are everywhere. In the grocery store, on TV... pregnant ladies and babies are all over the place. It's kind of that same scenario when a woman has a pregnancy scare- suddenly, the only commercials on TV are for ClearBlue and Pampers.
If you haven't gathered already, I default to self-deprecating humor. It's a defense mechanism I readily recognize in myself, and honestly, it's just the first way I cope with things. I realize this might make others uncomfortable, b/c they think I'm making light of my own terribly tragic issue. It's not that I'm poking fun, or that I don't realize the gravity of the situation. It's just the easiest way for me to talk about it around other people and not be a blubbering mess. As a writer, this comes of usually as cynicism, so I thought it necessary to preface the rest of this post with this caveat.
The day I found out, I cried so much. I cried at work, cried when I got home, cried during dinner, cried before bed, cried when I got up the next morning. My husband cried with me. He was as sad as I was for all the same reasons, and sadder still to see his wife in so much emotional pain. In that first week following both my Dx and the layoff, our marriage has become foundationally stronger than it has been in the last year. If there's a silver lining to be had in all of this, it's that I know I have indeed, a partner for life, through all of life's sorrows.
For the first week or so, I was stuck in the overwhelming sadness of the situation. I was watching futures disappear: of coming out of the bathroom with a positive HPT in hand, telling Arieh he's going to be a daddy; of seeing my child's face for the first time and playing the "gee, he looks like me or you" game; of surprising family and friends with creative, inventive ways with news that we're pregnant... What made me saddest is that we were deliberately waiting to TTC (try to conceive) for another 2 years, so that I had my master's completed, and we had a bigger nest egg. We were getting all of our ducks in a row because it was important to us that we are financially secure when we're ready to build our family. I felt like I was cheated.
In coping, I've moved into a much angrier stage right now. I'm in the "it's just not fucking fair" stage. Because, well, it's not. I'm taking a lot of my anger out on God right now. The good thing is that I haven't abandoned my faith entirely; you can't be angry at something you don't believe in. That's just a logical fallacy.
I've just finished reading Harold Kushner's When Bad Things Happen to Good People, and while I can rationally internalize the concepts he presents, emotionally, I'm just not ready to accept them. God is not to blame for this. Neither am I. Neither are my doctors. Kushner argues that suffering is not caused by God; it is random and indiscriminant. Kushner validates God's existence, saying that God is here to give us strength to work through our suffering. As His children suffers, so to does God. It's a lot to take in at once, and like I said- I get it, but I'm just not ready to accept it.
It's unfair and it angers me. While I appreciate the comments I've received that "well, there's always adoption or IVF," it's extremely frustrating. Why should I have to pay thousands of dollars to have my own children when millions of women have them for free? Like, I get there are thousands of unwanted babies/children out there, but why should I feel guilty for wanting my own biological children? If children are our legacy, our immortality: imagine how terribly isolating it must feel to know that the gene pool for your family stops at you.
I struggle with feelings of inadequacy. I did when I had my ovary removed too; I described it as though I were a tree with a broken branch at the time. That I wasn't a complete woman. Now, with my ability to have my own children practically robbed from me, the effect has been devastating to my gender identity. I'm not saying I think I'm a dude, but I sure do feel like less of a woman. I feel fat. I feel ugly. I feel useless. Rationally, I know these things are not true. Emotionally, it's a struggle every single day.
I'm fairly convinced at my followup appt on 4/24, my doctor will recommend counseling. Until then, I just continue to write. It's theraputic, and it helps me chronicle my emotional development. It doesn't make any of this necessarily any easier, but at least it's something I can do in a situation where I'm virtually helpless.
Initial Blood Tests, 3/13/09
Now that we have some idea of how all these hormones are supposed to work, here's what mine look like, and how my doctor has come to the Dx of POF.I had my blood labs completed on 3/13/09. Here's the rundown. (Normal ranges are in parentheses). I've included my thyroid workup b/c those numbers are important, but honestly, I don't feel like explaining hypothyroidism on this blog. So here's what Wikipedia has to say about hypothyroidism instead.
Thyroid Panel:
- TSH (Thyroid Stimulating Hormone) = 1.88 uIU/mL [0.34-5.60] Status: Normal
- Free T3 (Triiodothyronine) = 3.31 pg/mL [2.50-3.90] Status: Normal
- Free T4 (Thyroxine) = 0.92 ng/dL [0.54-1.24] Status: Normal
- Estradiol/E2 = 20 pg/dL [20-88 for post-menopausal women] Status: Low1
- Progesterone = 0.14 ng/dL [0.08-0.78 for post-menopausal women] Status: Low2
- Testosterone = 42 ng/dL [10-75] Status: Normal3
- FSH = 57.7 mIU/mL [23-116.3 for post-menopausal women] Status: High4
- LH = 34.0 mIU/mL [8.7-76.3 for mid-cycle] Status: Normal
- DHEA Sulfate (androgen) = 233 mcg/dL [43-320] Status: Normal
- Insulin = 22 uIU/mL [0-16] Status: High5
- Glucose = 83 mg/dL [70-105] Status: Normal
- Total Cholesterol = 197 mg/dL [less than 200] Status: Normal6
- Triglycerides = 219 mg/dL [48-150] Status: High7
- HDL = 44 mg/dL [23-95] Status: Normal8
- LDL = 109.2 mg/dL [75-130] Status: Normal9
- My ovaries are not producing enough estrogen on their own. This would account for my current amenorrhea. My levels are outside of non-pregnant females and in the post-menopausal female range.
- Because I am not ovulating, I'm not producing enough progesterone. My levels are outside of non-pregnant females and in the post-menopausal female range.
- Not terribly high, but high enough that it would explain my high sex drive. Arieh thinks it's funny that I have the hormones of a 16-year-old boy.
- Because there's not enough estrogen in my system, my pituitary gland is overcompensating and is pumping out extra amounts of FSH. My LH is in a holding pattern as a result; b/c there's no estrogen surge, the LH is just chillin' out, waiting for hormonal signals.
- Due to my thyroid, I am slightly insulin resistant. Thus, it's a general pain in the ass for me to lose weight. Also, I am at greater risk for developing diabetes, especially with familial history.
- This is the first my cholesterol has been under 200 in over a year. I am just skating by in terms of normal levels.
- Insulin resistance = increased levels of triglycerides. It all has to do with my decreased metabolism.
- Ideally, my HDL should be over 60 (this is the "good" cholesterol).
- Ideally, I need to decrease my LDL levels (this is the "bad" cholesterol).
April 4, 2009
Where do babies come from, anyway?
The ovaries are one amazing set of organs, I have learned in the few weeks following my Dx. Both reproductive and endocrine - you might call them the command center for the hormonal workings of the female body. Before you can understand anything about premature ovarian failure, you need to understand exactly how the female reproductive and endocrine systems work.
Short version
Uterus builds up endometrium (lining) in anticipation of release of egg. Ovary releases egg. If sperm is in wait, egg should fertilize. The fertilized egg travels down the fallopian tube to the uterus and implants in the endometrium. Cue: pregnancy. If there is no sperm to fertilize the egg, then the egg and endometrium are flushed out in that lovely process known as menstruation. And then the whole process starts over again.
For the visual learners
A Hormonal Primer
Let's take a look at exactly what's happening hormonally during a woman's cycle. If you've ever wondered why some women might get a little "moody" during their cycle, well, we've got a LOT going on at once hormonally in our bodies :)
Follicular (Pre-Ovulatory) Phase
The pituitary gland begins releasing FSH (Follicle Stimulating Hormone). This primes the ovary to start maturing its follicles, the individual part of the ovary that releases the eggs. During this phase, several follicles actually develop at once, on both ovaries, but only one follicle will mature and release an egg in most normal circumstances. Estradiol (estrogen) is released by the ovaries during this time, and aids in the building of the endometrial lining of the uterus.
Ovulatory Phase
As estrogen levels peak, it triggers the release of LH (Lutenizing Hormone) by the pituitary gland. Of all the developing follicles, one will mature and burst, releasing the egg. It is currently unknown how the body determines which of these follicles on which ovary will release an egg. The ruptured follicle then becomes the corpus luteum (Latin for "yellow body"), and begins to release progesterone. Progesterone is a heat-releasing hormone, and causes a woman's BBT (Basal Body Temperature) to rise. It's also responsible for hot flashes. Progesterone is essential to ensuring implantation of the fertilized egg and to sustain pregnancy. If the egg is fertilized, it will take about 7-10 days to implant in the uterus. Once implanted, the fertilized egg will begin to release the hormone hGC (Human Chorionic Gonadotropin). This is the hormone that POAS HPTs (pee-on-a-stick home pregnancy tests) are designed to detect. The corpus luteum will continue to release progesterone, until the placenta develops and takes over progesterone production for the duration of the pregnancy.
Luteal Phase
If the egg is not fertilized, the corpus luteum will begin to disintergrate, and thus, decrease the amount of progesterone released. The drop in progesterone causes a second rise in estrogen, which then triggers the uterus to shed the endometrium, inducing a woman's menses. And then it starts all over again.
What does this all mean for me?
Well, my remaining ovary isn't working anymore for some presently unknown reason, so NONE of this is happening in my body right now.
Short version
Uterus builds up endometrium (lining) in anticipation of release of egg. Ovary releases egg. If sperm is in wait, egg should fertilize. The fertilized egg travels down the fallopian tube to the uterus and implants in the endometrium. Cue: pregnancy. If there is no sperm to fertilize the egg, then the egg and endometrium are flushed out in that lovely process known as menstruation. And then the whole process starts over again.
For the visual learners
Image credit: Fertility Plus (http://www.fertilityplus.org/faq/hormonelevels.html)
A Hormonal Primer
Let's take a look at exactly what's happening hormonally during a woman's cycle. If you've ever wondered why some women might get a little "moody" during their cycle, well, we've got a LOT going on at once hormonally in our bodies :)
Follicular (Pre-Ovulatory) Phase
The pituitary gland begins releasing FSH (Follicle Stimulating Hormone). This primes the ovary to start maturing its follicles, the individual part of the ovary that releases the eggs. During this phase, several follicles actually develop at once, on both ovaries, but only one follicle will mature and release an egg in most normal circumstances. Estradiol (estrogen) is released by the ovaries during this time, and aids in the building of the endometrial lining of the uterus.
Ovulatory Phase
As estrogen levels peak, it triggers the release of LH (Lutenizing Hormone) by the pituitary gland. Of all the developing follicles, one will mature and burst, releasing the egg. It is currently unknown how the body determines which of these follicles on which ovary will release an egg. The ruptured follicle then becomes the corpus luteum (Latin for "yellow body"), and begins to release progesterone. Progesterone is a heat-releasing hormone, and causes a woman's BBT (Basal Body Temperature) to rise. It's also responsible for hot flashes. Progesterone is essential to ensuring implantation of the fertilized egg and to sustain pregnancy. If the egg is fertilized, it will take about 7-10 days to implant in the uterus. Once implanted, the fertilized egg will begin to release the hormone hGC (Human Chorionic Gonadotropin). This is the hormone that POAS HPTs (pee-on-a-stick home pregnancy tests) are designed to detect. The corpus luteum will continue to release progesterone, until the placenta develops and takes over progesterone production for the duration of the pregnancy.
Luteal Phase
If the egg is not fertilized, the corpus luteum will begin to disintergrate, and thus, decrease the amount of progesterone released. The drop in progesterone causes a second rise in estrogen, which then triggers the uterus to shed the endometrium, inducing a woman's menses. And then it starts all over again.
What does this all mean for me?
Well, my remaining ovary isn't working anymore for some presently unknown reason, so NONE of this is happening in my body right now.
April 1, 2009
Understanding Premature Ovarian Failure
Premature ovarian failure was originally termed "premature menopause." The term premature ovarian failure more accurately reflects what is happening within the body. Essentially, if ovarian function ceases before age 40, it's considered POF. Here's a very informative news segment from October 2008 that serves as a great overview of POF:
Fast Facts: What Is Premature Ovarian Failure?
(Source: International POF Association Fact Sheet)
Fast Facts: What Is Premature Ovarian Failure?
(Source: International POF Association Fact Sheet)
- POF affects about 1-4% of women before age 40, or about 250,000-1 million women nationally.
- Women are generally born with enough eggs in their ovaries so that they ovulate one each month from puberty until about the age of 50. At that time, the supply of eggs is used up and menopause occurs. But, in girls and young women with POF, something has happened to the supply of eggs in the ovaries at a young age. It could be a loss of eggs, a dysfunction of the eggs or the removal of the ovaries at a young age. Unlike menopause, this is not a natural occurrence. This loss of ovarian function is occurring at too young an age to be considered a natural, although premature, menopause. Premature Ovarian Failure usually occurs in women under the age of 40 and can happen as early as the teen years.
- Many times, the cause of POF is never determined, but can be traced to genetics, autoimmune disorders, or surgical intervention.
- About 6-8% of women with POF will conceive naturally, however, many build families using egg donors/IVF or adoption.
- Currently, there is no known way to induce the ovaries to begin ovulating naturally again.
- POF carries increased risks of osteoporosis and heart disease because of the decreases in the reproductive hormones that protect women during their childbearing years. HRT (hormone replacement therapy) is the recommended treatment for women with POF.
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